Blood lead levels and bladder cancer among US participants: NHANES 1999–2018

Abstract Background and objectives Pb (lead) is a heavy metal, its carcinogenicity for bladder cancer is still debated, the link between blood lead levels (BLLs) and bladder cancer was investigated in this study. Methods This cross-sectional study, using the NHANES (1999–2018) database, explored the...

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Main Authors: Mei Huang, Hongxiao Li, Jiahui Chen, Liuqiang Li, Yifei Zhan, Yuxuan Du, Jun Bian, Meiling Chen, Dehui Lai
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21549-2
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author Mei Huang
Hongxiao Li
Jiahui Chen
Liuqiang Li
Yifei Zhan
Yuxuan Du
Jun Bian
Meiling Chen
Dehui Lai
author_facet Mei Huang
Hongxiao Li
Jiahui Chen
Liuqiang Li
Yifei Zhan
Yuxuan Du
Jun Bian
Meiling Chen
Dehui Lai
author_sort Mei Huang
collection DOAJ
description Abstract Background and objectives Pb (lead) is a heavy metal, its carcinogenicity for bladder cancer is still debated, the link between blood lead levels (BLLs) and bladder cancer was investigated in this study. Methods This cross-sectional study, using the NHANES (1999–2018) database, explored the relationship between BLLs and bladder cancer among Americans aged 20–85. It employed weighted multivariable logistic regression for analysis. Additionally, subgroup analyses and smoothed curve fitting were also performed. Results This study included a total of 40,486 participants, the body mass index (BMI) of the participants is 28.71 ± 6.68 kg/m2. The average BLL is 0.0858 μmol/L (range: 0—2.96 μmol/L). A fully adjusted model showed that the BLL was associated with bladder cancer (odds ratio [OR] = 2.946, 95% confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28 kg/m2. However, no difference was found in the BMI ≥ 28 kg/m2 subgroup or in the general population. According to the subgroup analysis of participants with a BMI < 28 kg/m2, blood lead was associated with bladder cancer in the male, nonhypertensive, and < 70-year-old subgroups (p < 0.05) but no significantly different is observed in other subgroups. In addition, we discovered a nonlinear association between the BLLs and bladder cancer risk using a linear regression model. Conclusion In this cross-sectional study, we found that the degree of correlation between BLLs and the risk of bladder cancer may vary among people with different BMIs. In people with BMI < 28 kg/m2, a higher BLL was independently associated with bladder cancer. However, more experiments are needed to confirm this finding.
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spelling doaj-art-0d00914530c04b2bb3b46bcad71da4212025-02-02T12:45:40ZengBMCBMC Public Health1471-24582025-02-0125111110.1186/s12889-025-21549-2Blood lead levels and bladder cancer among US participants: NHANES 1999–2018Mei Huang0Hongxiao Li1Jiahui Chen2Liuqiang Li3Yifei Zhan4Yuxuan Du5Jun Bian6Meiling Chen7Dehui Lai8Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityDepartment of Urology, The Fifth Affiliated Hospital of Guangzhou Medical UniversityAbstract Background and objectives Pb (lead) is a heavy metal, its carcinogenicity for bladder cancer is still debated, the link between blood lead levels (BLLs) and bladder cancer was investigated in this study. Methods This cross-sectional study, using the NHANES (1999–2018) database, explored the relationship between BLLs and bladder cancer among Americans aged 20–85. It employed weighted multivariable logistic regression for analysis. Additionally, subgroup analyses and smoothed curve fitting were also performed. Results This study included a total of 40,486 participants, the body mass index (BMI) of the participants is 28.71 ± 6.68 kg/m2. The average BLL is 0.0858 μmol/L (range: 0—2.96 μmol/L). A fully adjusted model showed that the BLL was associated with bladder cancer (odds ratio [OR] = 2.946, 95% confidence interval [CI] = 1.025 to 8.465, P = 0.047) in people with BMI < 28 kg/m2. However, no difference was found in the BMI ≥ 28 kg/m2 subgroup or in the general population. According to the subgroup analysis of participants with a BMI < 28 kg/m2, blood lead was associated with bladder cancer in the male, nonhypertensive, and < 70-year-old subgroups (p < 0.05) but no significantly different is observed in other subgroups. In addition, we discovered a nonlinear association between the BLLs and bladder cancer risk using a linear regression model. Conclusion In this cross-sectional study, we found that the degree of correlation between BLLs and the risk of bladder cancer may vary among people with different BMIs. In people with BMI < 28 kg/m2, a higher BLL was independently associated with bladder cancer. However, more experiments are needed to confirm this finding.https://doi.org/10.1186/s12889-025-21549-2Blood lead levelBladder cancerNational Health and Nutrition Examination Survey (NHANES)Carcinogenicity
spellingShingle Mei Huang
Hongxiao Li
Jiahui Chen
Liuqiang Li
Yifei Zhan
Yuxuan Du
Jun Bian
Meiling Chen
Dehui Lai
Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
BMC Public Health
Blood lead level
Bladder cancer
National Health and Nutrition Examination Survey (NHANES)
Carcinogenicity
title Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
title_full Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
title_fullStr Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
title_full_unstemmed Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
title_short Blood lead levels and bladder cancer among US participants: NHANES 1999–2018
title_sort blood lead levels and bladder cancer among us participants nhanes 1999 2018
topic Blood lead level
Bladder cancer
National Health and Nutrition Examination Survey (NHANES)
Carcinogenicity
url https://doi.org/10.1186/s12889-025-21549-2
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